Supportive Care Of New Hampshire Llc | |
20 Chester Rd Derry NH 03038-1636 | |
(718) 298-4375 | |
Not Available |
Full Name | Supportive Care Of New Hampshire Llc |
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Speciality | Psychologist |
Location | 20 Chester Rd, Derry, New Hampshire |
Authorized Official Name and Position | Raphael Lichtschein (PRESIDENT) |
Authorized Official Contact | 7182984375 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Supportive Care Of New Hampshire Llc 27 Randolph Rd Howell NJ 07731-8611 Ph: (718) 298-4375 | Supportive Care Of New Hampshire Llc 20 Chester Rd Derry NH 03038-1636 Ph: (718) 298-4375 |
NPI Number | 1013657618 |
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Provider Enumeration Date | 03/31/2022 |
Last Update Date | 03/31/2022 |
Certification Date | 03/29/2022 |
Medicare PECOS PAC ID | 9133506272 |
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Medicare Enrollment ID | O20220511001843 |
Identifier | Type | State | Issuer |
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1013657618 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
Provider Name | Lisa G Donnellan |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1902090541 PECOS PAC ID: 6002903622 Enrollment ID: I20141008001850 |
Provider Name | Tonya Watkins |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1184091639 PECOS PAC ID: 5597073973 Enrollment ID: I20151005001939 |
Provider Name | Kathy M Boyd |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1811373913 PECOS PAC ID: 8022326172 Enrollment ID: I20151009000333 |
Provider Name | Kerry O'hara |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1265989438 PECOS PAC ID: 5597043125 Enrollment ID: I20161101002387 |
Provider Name | Marie Jane Germono Lord |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1023485307 PECOS PAC ID: 0143539262 Enrollment ID: I20170127001228 |
Provider Name | Bobbie-jo M. Johnstone |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1134666175 PECOS PAC ID: 1557645587 Enrollment ID: I20170310001252 |
Provider Name | Olivia Lea Clement |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1033713110 PECOS PAC ID: 3779995717 Enrollment ID: I20210513001723 |
Provider Name | Angelique Donati |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1205595055 PECOS PAC ID: 2062808751 Enrollment ID: I20220406000038 |
Provider Name | Michael Nicholas |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1437536166 PECOS PAC ID: 8224413158 Enrollment ID: I20220913003753 |
Provider Name | Nicole Sauve |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1770981243 PECOS PAC ID: 6800263435 Enrollment ID: I20221111000848 |
Provider Name | Cynthia Ann Kenney |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1043572571 PECOS PAC ID: 9830567353 Enrollment ID: I20221115000073 |
Provider Name | Melissa Muriel |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1265154850 PECOS PAC ID: 9335518620 Enrollment ID: I20221208000850 |
Provider Name | Suzanne Lynne Macaluso |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1821467259 PECOS PAC ID: 3375916109 Enrollment ID: I20230227001208 |
Provider Name | Juliette W Daniels |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1396266938 PECOS PAC ID: 9436514783 Enrollment ID: I20230420002369 |
Provider Name | Eva Torres Maldonado |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1164881736 PECOS PAC ID: 9032491022 Enrollment ID: I20230516000080 |
Provider Name | Wendy Marie Prescott |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1356444368 PECOS PAC ID: 8820454937 Enrollment ID: I20230516001404 |
Provider Name | Dana Rosa Phillips |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1790475986 PECOS PAC ID: 1658739057 Enrollment ID: I20230616000401 |
Provider Name | Joseph Mckee |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1801596713 PECOS PAC ID: 0042671653 Enrollment ID: I20230814003419 |
Provider Name | Christiana Nsoh |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1922870757 PECOS PAC ID: 9537519368 Enrollment ID: I20231220001263 |
Provider Name | Martha Hanley |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1417718800 PECOS PAC ID: 9739522939 Enrollment ID: I20240205002092 |
Provider Name | Deanna Pangione |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1518725746 PECOS PAC ID: 1355788472 Enrollment ID: I20240326000715 |
Provider Name | Renee April Laurencelle |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1164129979 PECOS PAC ID: 7012372899 Enrollment ID: I20240329001772 |
Provider Name | Oluyemisi Olatilu |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1073374625 PECOS PAC ID: 2860832961 Enrollment ID: I20240506001502 |
Provider Name | Katie A Maclean |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1639924731 PECOS PAC ID: 1850732678 Enrollment ID: I20240510002241 |
Provider Name | Danielle Mcgovern |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1417703497 PECOS PAC ID: 3971944695 Enrollment ID: I20240513002972 |
Provider Name | Nicole Marie Mancino |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1831958750 PECOS PAC ID: 8820439441 Enrollment ID: I20240514003304 |
Provider Name | Rutendo Faith Moyo |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1992175624 PECOS PAC ID: 5496125619 Enrollment ID: I20240515003528 |
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